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Introduction. According to different authors, 4 to 40% of the child and adult population suffer from chronic tonsillitis (СT), with many authors noting an increase in the number of cases and no tendency to decrease the frequency of this pathology.Objective. To optimize diagnostics and treatment tactic of taking patients with chronic tonsillitis (CT) using our own clinical and laboratory data and morphological data as well as literature data.Materials and methods. Аt the first stage of work, 166 patients were examined. They were divided into 4 categories (experimental groups) depending on clinical CT classification according to B.S. Preobrazhensky and V.T. Palchun. We also formed a group of patients who did not have CT symptoms. All patients underwent tonsillectomy or tonsillotomy. All tissue samples of palatine tonsils we got were investigated using immunohistochemical markers and default histological colorings. At the second stage, the dynamics of complaints, clinical symptoms and laboratory parameters were assessed in 247 patients diagnosed with CT Toxic-Allergic Form I (CT TAF I) before conservative treatment and 3 months after conservative treatment. Patients were divided into 3 groups depending on the conservative treatment regimen: a course of flushing the lacunae of the tonsils; antibiotic therapy with a retard form of clarithromycin; complex treatment combining the first two options.Results. Тhe chronic inflammatory process in the palatine tonsils changes their cytoarchitectonics. At the same time, there is a direct correlation between the presence and severity of changes with the clinical classification of chemotherapy according to B.S. Preobrazhensky and V.T. Palchun.Conclusion. With CT TAF II, the palatine tonsil not only loses its importance as an organ of the immune system, but also becomes a hotbed of infection in the body, which can cause severe complications. Only tonsillectomy can effectively protect the patient from these complications. At the stage of CT TAF I, the formation of metatansillar complications occurs. Patients with this form of CT require special attention, and correctly conducted conservative therapy can protect patients from local and general complications of CT. A variant of such conservative therapy that gives a lasting effect is complex therapy with washing the lacunae of the palatine tonsils with an antiseptic solution and simultaneous antibiotic therapy with 14-membered macrolides that can accumulate in the lymphadenoid tissue.

The article is devoted to the problem of chronic tonsillitis. The aim of the study was to assess changes in the morphofunctional state of the palatine tonsils in chronic inflammation. The study presents comparative data of immunohistochemical examination of the tonsils in normal and chronic tonsillar pathology. The authors used the clinical classification of chronic tonsillitis developed by B.S. Preobrazhensky and V.T. Pal’chun. Histological changes in the palatine tonsils of patients with toxic-allergic form 2 chronic tonsillitis were described in accordance with this classification. The control group represented palatine tonsils tissue taken from patients without chronic tonsillitis. The examination was carried out using markers of apoptosis, antiapoptosis, cell proliferation, as well as various types of lymphocytes. The authors describe a tonsil tissue handling technique, morphological and functional state in each study group, compared the studied parameters in two groups, reflected the dynamics of changes in the palatine tonsils with chronic tonsillitis. Increased apoptotic and anti-apoptotic activity combined with decreased cell proliferation, increased number of T-helpers and B-lymphocytes gives evidence of significantly decreased functional activity of the palatine tonsils in chronic inflammation. These changes are correlated with the clinical picture to develop the most optimal management of the disease.

Introduction. The immune function of the palatine tonsils is associated with a constant proliferation of lymphocytes, therefore, the indicators of proliferation, apoptosis and anti-apoptotic activity in the palatine tonsils are quite informative for assessing their functional state and contribution to adaptive immunity. Chronic inflammation in the palatine tonsils affects their functional state. Understanding the immunocompetence of the palatine tonsils at different stages of the course of chronic tonsillitis allows the optimal tactics of treating this disease, including timely tonsillectomy.Objective. Based on the results of research and literature sources, to find a comparative characteristic of the contribution of palatine tonsils to adequate immunity, ways to assess their proliferative and anti-apoptotic activity.Materials and methods. The study included 158 patients with various forms of chronic tonsillitis and 8 patients without signs of chronic tonsillitis, who were divided into 4 study groups, in accordance with the clinical classification of chronic tonsillitis according to B.S. Preobrazhensky and V.T. Palchun. The tissue samples of the palatine tonsils obtained from patients were examined immunohistochemically in an automatic mode using markers of Ki67 proliferation and Bcl2 antiapoptosis.Results. When conducting an immunohistochemical study with markers of  proliferation and anti-apoptosis, an increase in the proliferative and anti-apoptotic activity of lymphoid tissue cells in chronic tonsillitis of a simple form was revealed, and a significant decrease in these indicators in chronic tonsillitis of toxic-allergic forms of I and II stage.Conclusions. Data were obtained on the planned tonsillectomy in chronic tonsillitis of the toxic-allergic form of II degree, as well as in case of ineffectiveness of conservative therapy of tonsillitis of toxic-allergic form of I degree.